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Rathke’s cleft cysts (RCCs) were diagnosed mostly by shape, signal intensity and enhancement characteristics on MR images.
To identify the diagnosis of RCC by an improved understanding about the cyst’s localization in reference to the pituitary gland.
Patients and We retrospectively evaluated 124 patients with pituitary cystic lesions, verified surgically and histologically. The patients were divided into RCC and cystic pituitary adenoma (CPA) groups. The cysts in both groups were observed and compared, focusing on the shape and size, as well as clinical and MRI features, especially localization. Receiver-operating-characteristic (ROC) curve was performed with the clinical and MRI findings between the groups.
The RCC group included 90 patients (33 men) with a mean age of 40.9 years, while the CPA group included 34 patients (12 men) with a mean age of 43.5 years. On MRI, the RCCs were mostly located without shift of the pituitary stalk on the coronal view, with the superior margin of the cyst lying behind or across the junction point of the pituitary stalk on the sagittal view. The ROC curve was performed, and the following two variables exhibited good performances in diagnosing RCCs: the coronal localization (sensitivity, 91.1%; specificity, 79.4%; AUC = 0.853, 95% confidence interval: 0.778 - 0.910, P Cyst localization, observed easily on MRI, can be used as an effective parameter for diagnosing RCC and distinguishing it from a CPA.

Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies.